Related Experiment Video
Updated: Sep 17, 2025
The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
Published on: November 4, 2010
Colostomy complications in patients with anorectal malformations
Tobias Klein1,2, Gloria Stephany Guarnizo-Diaz3, Alexander Semaan4
1Department of Pediatric and Adolescent Surgery and Pediatric Urology, Children's Hospital of Cologne, Kliniken der Stadt Köln gGmbH, Amsterdamer Straße 59, 50735, Cologne, Germany. 7081.klein@gmail.com.
Purpose:
Anorectal malformations (ARM) are a common reason for protective colostomy in children, but there is no consensus on the best type or location. The objective of this study is to assess the prevalence of colostomy malposition in clinical settings with limited expertise in the management of patients with anorectal malformations, as well as the associated complications of colostomy.
Methods:
Medical records of all children with ARM treated at our hospital between 2005 and 2019 were retrospectively reviewed. The incidence of stoma complications and the rates of colostomy revision during ARM repair were compared by colostomy type and location.
Results:
The study included 276 children. A proximal colostomy was performed in 205 cases (74.3%) and a distal colostomy in 71 cases (25.7%). Loop colostomies were done in 233 patients (84.4%), while split colostomies were done in 43 (15.6%). Stoma-related complications occurred in 65 patients (23.6%), with prolapse (8.3%) and maceration (4.0%) being the most common. Complications were significantly lower with proximal colostomies (20.2% vs. 32.9%, p = 0.036) and loop stomas (21.0% vs. 37.2%, p = 0.030). Stoma revision due to malposition was needed in 39.4% of patients with distal colostomies, but none with proximal colostomies (p < 0.0001).
Conclusions:
Colostomy in children with ARM is associated with a high overall complication rate. In particular, many distal colostomies are incorrectly placed too distally, which complicates subsequent corrective surgery.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:24Ostomy Care
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...